宋秀豹,史长征,洪其生.体外冲击波治疗足底筋膜炎的疗效研究[J].中华物理医学与康复杂志,2019,41(6):434-438
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| 体外冲击波治疗足底筋膜炎的疗效研究 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2019.06.009 |
| 中文关键词: 足底筋膜炎 体外冲击波治疗 磁共振成像 疗效 |
| 英文关键词: Plantar fasciitis Extracorporeal shock wave therapy Magnetic resonance imaging Therapeutic effectiveness |
| 基金项目:广东省科技计划项目（编号2017A020215065）；广东省中医药局科研项目（编号20191094） |
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| 中文摘要: |
| 目的 探讨体外冲击波治疗足底筋膜炎前后T2值的变化及其对足底筋膜炎疗效的评估价值。 方法 对符合条件的23例足底筋膜炎患者行体外冲击波治疗，每周1次，3次为1个疗程，治疗前及首次治疗后4 h行磁共振检查，治疗前及疗程结束1个月后分别对患者进行视觉模拟评分法（VAS）、足跟压痛指数（HTI）、美国矫形外科足踝协会（AOFAS）踝-后足评分系统评价，并记录患者治疗前后的最长行走时间。对患者治疗前后筋膜、肌肉、脂肪垫T2值，最长行走时间及患者VAS评分进行比较，采用Pearson相关分析上述感兴趣区T2值变化量与VAS评分变化量的相关性。 结果 经冲击波治疗后患者的VAS评分、HIT评分、AOFAS评分较治疗前明显改善，最长行走时间明显延长。磁共振成像显示治疗后4 h筋膜及周围软组织的水肿程度增加，T2压脂高信号影的范围及程度增多，T2值变化量与VAS评分变化量呈正相关。 结论 体外冲击波对足底筋膜炎有较好的疗效，可明显减轻足部疼痛，改善足部运动功能，治疗后磁共振T2值的变化能够反映足底筋膜炎的疗效。 |
| 英文摘要: |
| Objective To explore the long-term effectiveness of using extracorporeal shock waves in the treatment of plantar fasciitis. Methods Extracorporeal shock wave therapy was applied to 23 plantar fasciitis sufferers once a week for three weeks. MRI examinations were performed before and 4 hours after the first treatment. Before the treatment and one month after it was complete, all of the patients rated their pain using a visual analogue scale (VAS), and their infirmity was quantified using a heel tenderness index (HTI) and the ankle-hind foot scale of the American Orthopaedic Foot and Ankle Society (AOFAS). The longest walking time was also recorded. Paired t-tests compared the T2 values of the fascia, muscles and fat pads, the longest walking time and the VAS scores before and after the treatment. Pearson correlation coefficients were evaluated to test the significance of any correlation between the T2 changes and the changes in the VAS scores. Results After the shock wave therapy, the average VAS, HIT and AOFAS scores had significantly decreased, while the longest walking time had increased significantly. The magnetic resonance imaging showed increased edema in the fascia and their surrounding soft tissues. And the extent and degree of the T2 weighted high signal increased four hours after the treatment. The changes in the T2 values correlated positively and significantly with the changes in the VAS scores. Conclusion Extracorporeal shock waves have an excellent therapeutic effect on plantar fasciitis. They can significantly relieve heel pain and improve foot movement. |
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